Multiple myeloma treatment options
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The goal of treating multiple myeloma (MM) is remission. Remission means that MM cells are so few they can no longer be detected by tests, and your health has improved. To keep MM under control and not have cancer cells grow back as long as possible, you need to continue treatment as your doctor recommends.
When it comes to treatment, it's all about a personalized plan that works best for you.
Stem cell transplant
Depending on factors including your age and overall health, a stem cell transplant may be an option. A stem cell transplant is a treatment in which healthy cells are infused into your bone marrow. These cells help boost new bone marrow production and decrease multiple myeloma cell activity. To prepare for a transplant, you will first receive high-dose chemotherapy to kill as many MM cells as possible.
Studies show that Black people are less likely to receive the option of a stem cell transplant. However, there is evidence that transplants can improve outcomes for Black people. You should talk with your doctor about this option and decide whether it is right for you.
Types of medicine
Different medicines work in different ways, so combining them is often the best way to manage MM. Your doctor may put you on as many as four medicines to manage MM. Upon diagnosis, your doctor might discuss some of these medicines or treatments, including:
Is treatment with medicines that kill or control the growth of cancer cells, shrink tumors, and stop them from spreading. These medicines can be taken by mouth or injected directly into the bloodstream so they can reach every part of the body. In order to attack MM in multiple ways and make the treatment more tolerable, your doctor may combine a chemotherapy drug with a steroid or an immunomodulating drug.
Can be used alone or as part of a combination of medicines to fight MM. These medicines can help decrease nausea and vomiting from chemotherapy.
That send signals to the immune system to destroy cancer cells. Patients on this class of medication are carefully monitored because they must not become pregnant while on the drug due to the risk of severe birth defects. Medicines in this class can also increase the risk of blood clots and are usually taken with aspirin or other blood thinners.
Stop important enzyme actions inside cancer cells that help them grow and spread. Tumor cells may be more impacted than normal cells with this type of treatment, but some side effects should still be expected.
Monoclonal antibodies that target and kill cancer cells directly and help the immune system attack them as well.
Subclass - Anti-CD38 protein antibodies
This type of monoclonal antibody attaches to an accessible surface CD38 protein found on multiple myeloma cells to mark them for the immune system, and it is believed that this action can also kill the cancer cells directly.
Commonly used with other medications to treat MM, it can also be used alone in patients who have not reached their goal with other myeloma treatments.
Learn more about anti-CD38 protein antibody treatments.
Subclass - SLAMF7 protein antibody
Researchers believe this monoclonal antibody that attaches to SLAMF7, another protein on the surface of the multiple myeloma cells, helps the immune system attack MM cells. SLAMF7 protein antibodies are delivered as an infusion into a vein.
Subclass - Antibody-drug conjugates
This type of MM treatment combines a monoclonal antibody with chemotherapy to target and kill cancer cells. These medicines attach to specific proteins like BCMA (B-cell maturation antigen, a substance more often found in malignant MM cells, which makes it a good marker to find cancer cells) on cancer cells and then deliver chemotherapy to that cell.
Subclass - CAR-T cell therapy
This is a very advanced type of immunotherapy where a person’s T-cells are collected from their blood and the genes inside them are changed to make them better cancer fighters by adding chimeric antigen receptors to the outside of the cell wall.
Chemotherapy is used to prepare the patient’s body to receive the modified T-cells, which are put back into their bloodstream through an IV infusion. These cells are now armed to seek out and kill the multiple myeloma cells. This treatment is performed only once, and the care team will watch you closely for 4-6 weeks afterward.
Find more information on a specific CAR-T cell therapy.
This class of medicines uses innovative science to bind to one target on the surface of MM cells and another target on T-cells. Bispecific antibodies that are currently approved to treat MM target either BCMA (B-cell maturation antigen) or GPRC5D (G protein-coupled receptor, class C, group 5, member D) on the surface of MM cells and engage T-cells to activate the immune system.
Learn about a bispecific treatment that targets BCMA protein.
Learn about a bispecific treatment that targets the GPRC5D protein.
Stop. the myeloma cells from moving proteins out of their nucleus, which kills the cell.
Clinical trials
New medicines are always being developed. We understand feeling nervous about new medications, but clinical trials are important for a number of reasons:
- They could help to change a long history of underrepresentation about the impact of medicine on Black people
- They are a good way to get research-based treatments that aren’t yet available to the public
- They can help to provide information about which treatments work best for us
Be sure to talk with your doctor about all treatment options, including their pros and cons, so you can make the choice that works best for you.